Table of ContentsView AllTable of ContentsSigns to Seek Medical CareSerious CausesAcute InjuriesOther CausesDiagnosisTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Signs to Seek Medical Care
Serious Causes
Acute Injuries
Other Causes
Diagnosis
Treatment
Prevention
There are many different causes of calf pain. It may be directly related to your calf muscles—including the innergastrocnemiusand outersoleusmuscles—or the tendons, bones, nerves, and blood vessels supporting and serving the calf.
The most common causes ofcalf painare relatively harmless and readily treatable. Others may be serious and harder to treat, so it is important not to ignore calf pain if it is severe, persistent, or unresolvable with conservative treatment.
Verywell / Joshua Seong
If you’re not sure what is causing your calf pain, you should contact your healthcare provider. This is especially true if the pain is persistent, severe, or worsening.
Some signs you should see a healthcare provider include:
Treatment depends entirely on the cause of the problem, and some conditions that cause calf pain can easily be confused with others. Getting a proper diagnosis can ensure you get the treatment you need.
Serious Causes of Calf Pain
Deep Vein Thrombosis (DVT)
DVT often occurs when someone is seated in a stationary position for a long period of time, such as during a long-haul air flight. People with cardiovascular disease, obesity, and other conditions are predisposed to developing these clots.
DVT Is an EmergencyDVT is a medical emergency that can lead topulmonary embolism(a blood clot in the lungs) if the clot breaks off and travels. Seek immediate medical attention if you have pain, swelling, and tenderness in your leg and develop breathlessness and chest pain.
DVT Is an Emergency
DVT is a medical emergency that can lead topulmonary embolism(a blood clot in the lungs) if the clot breaks off and travels. Seek immediate medical attention if you have pain, swelling, and tenderness in your leg and develop breathlessness and chest pain.
Achilles Tendonitis or Rupture
The Achilles tendon is the largest tendon in the body. It is located on the back side of your leg and connects your calf muscle to your heel bone.
When the tendon becomes irritated, usually due to overuse, you may experience the following symptoms ofAchilles tendonitis:
A torn tendon is referred to as an Achilles tendon rupture. When the tendon tears, you may experience:
Peripheral Artery Disease (PAD)
Osteomyelitis
With this condition, you may experience:
Bone Fracture
A complete bone break can cause your leg to look deformed. This can also happen if the broken bone does not heal properly. To prevent this from happening, you may need a cast or possibly surgery.
Gastrocnemius Muscle Strain
Amedial gastrocnemius strainis an acute injury that happens when the largest muscle of the calf is abruptly overstretched. Small tears in the muscle fibers cause the pain.
Gastrocnemius strains often happen during sports or activities that involve sprinting or jumping, including tennis and soccer.
If you strain your gastrocnemius muscle, you may experience the following symptoms:
The pain may be too intense to walk, or you may start limping to avoid putting weight on the injured leg. If untreated, this may lead to a muscle tear.
Calf Muscle Contusion
A calfmusclecontusion, otherwise known as a bruise, happens when blood vessels under the skin are torn or ruptured. As a result, the blood vessels leak into the muscle tissues.
This type of injury often occurs after a person falls, bumps into something, or is struck on the calf.
Typically, a contusion leads to symptoms such as:
With rest and rehabilitation, blood beneath the skin will reabsorb into your body as the contusion heals.
Occasionally, contusions can lead to ahematoma(a pool of blood under the skin) that may take longer to heal or require surgical drainage.
Plantaris Muscle Rupture
Aplantarismuscle rupture(tear) can occur when a lot of weight is suddenly placed on the ankle while the knee is extended. This small, superficial muscle is situated behind the knee and runs between the gastrocnemius and soleus muscles.
You may feel a sudden, snapping or popping pain in the back of your leg when the injury occurs.Bruising, swelling, and pain may take a few minutes, hours, or even days to develop. Some people may also experience cramping.
Fortunately, this injury tends to heal on its own.
Peroneal Nerve Entrapment
Theperonealnerve is most prone to nerve entrapment. When this nerve is pinched, you may feel:
In severe cases, peroneal nerve entrapment can lead tofoot drop, in which you have difficulty lifting the front of your foot due to muscle weakness.
Popliteus Tendonitis or Tear
Thepopliteustendon wraps around your knee joint, connecting your thighbone to yourpopliteusmuscle just below the knee. Your popliteus tendon and popliteus muscle work together to rotate and stabilize your knee.
Popliteus tendonitis happens when the tendon is inflamed, usually due to overuse. It causes pain just above the calf and in the back and side of the knee. The pain worsens when walking or running downhill.
Sometimes, calf pain is not a result of a specific trauma. Symptoms can develop over time due to overuse, underlying health conditions such as arthritis, or even be present at birth.
Calf Muscle Cramp
Acalf muscle crampis a sudden, involuntary contraction of one or more calf muscles. These are often referred to as “Charley horses.”
Around 30–37% of all people experience calf cramps.The cramps can last between a few seconds and 10 minutes.
Calf cramps may come with the following symptoms:
Afterward, your calf muscle may be sore for a few days.
Calf cramps may be due to:
Soleus Muscle Strain
Thesoleusmuscle plays an important role in lifting the heel off the ground. It also stabilizes your posture as you walk or run, preventing you from falling forward.
If you have a soleus muscle strain, you may feel deep soreness or tightness when you do the following:
Soleus muscle strain is a common overuse injury in endurance running.However, many runners do not notice any particular incident that caused it.
Symptoms tend to develop over time, and they include:
These symptoms may worsen until it is too difficult to run at all.
How Long Do Calf Strains Last?The time it takes for acalf strainto heal depends on the muscle involved, as well as the type and severity of the injury. Many calf strains heal on their own within a few weeks, but others may need treatment and a longer recovery period.
How Long Do Calf Strains Last?
The time it takes for acalf strainto heal depends on the muscle involved, as well as the type and severity of the injury. Many calf strains heal on their own within a few weeks, but others may need treatment and a longer recovery period.
Baker’s Cyst
ABaker’s cystis a collection of knee joint fluid that pools in the back of the knee. This is common in people who have arthritis.
If a Baker’s cyst ruptures, the fluid may leak down into the calf region, causing:
The condition tends to revolve on its own.
Sciatica
Asciatic nerve, the largest nerve in the body, is found in both the right and left legs. It sends nerve impulses back and forth between the leg and spine and controls leg motion.
Sciatic nerve pain(also called sciatica) is very common and runs from the lower back down to the legs, as far as the calf. As with many chronic pain conditions, some people find they have more calf muscle pain at night.
Symptoms of sciatica are typically felt only on one side of the body, usually starting in the lower back and possibly extending to the leg, calf, foot, and toes. They include:
Popliteal Artery Entrapment
Poplitealartery entrapment happens when the gastrocnemius muscle places pressure on the popliteal artery at the back of the leg and knee. This can restrict blood flow in the leg.
The condition may be congenital (present at birth) or develop over time. It is commonly seen in young athletes as their popliteal artery becomes compressed while their body is still growing.
The symptoms of popliteal artery entrapment include:
These occur particularly after a vigorous lower leg workout (such as cycling or running).
To diagnose your calf pain, a healthcare provider will likely perform a physical exam and ask you about your medical history. Other tests may be performed based on the initial findings.
Medical History
Prior to your healthcare provider’s visit, it’s a good idea to jot down a couple of notes about your calf pain that could help your healthcare provider pinpoint the cause. For example:
In addition to asking about the specifics of your calf pain, your healthcare provider will want to know if you have any health problems. Be sure to tell them about any recent injury or trauma you may have had.
Physical Examination
During the physical exam, your healthcare provider will inspect and press on (palpate) your lower leg in order to look for signs of swelling, tenderness, warmth, and discoloration or redness. They may also check your reflexes and feel for your pulse in your leg, ankle, and foot.
Lastly, they will maneuver your foot, ankle, and knee to see how well you’re able to move them. They will likely perform other special tests if they suspect a certain diagnosis.
TheThompson testis one example. During this test, you’ll be asked to lie flat on an examination table with your foot hanging over the edge. Your healthcare provider then squeezes your calf muscle. If your toes do not flex downward, an Achilles tendon rupture would be suspected.
Blood Tests
Certain blood tests may help identify the cause of calf pain.Erythrocyte sedimentation rate (ESR)andC-reactive protein (CRP)tests can detect general inflammation common with infections.
AD-dimer testmay be ordered to help diagnose DVT or pulmonary embolism.D-dimers are fragments of proteins the body produces as it breaks blood clots down, so a positive test means there may be a blood clot somewhere in your body.
Imaging
X-rayscan reveal many types of abnormalities in the lower leg, ankle, or knee (particularly problems with bones and joints).
Anultrasound (sonogram)ormagnetic resonance imaging (MRI)may be used to evaluate calf tendon injuries and tears.
If your healthcare provider suspects a blood clot, they may order a vascular study to confirm the diagnosis. This type of ultrasound is used to check the blood flow in your veins and arteries.
1:31Click Play to Learn How to Treat and Prevent Calf Pain
1:31
Click Play to Learn How to Treat and Prevent Calf Pain
Rest, elevation, and ice application are among the fastest ways to relieve calf pain.And in many cases, they are sufficient.
If home treatment doesn’t work, or your pain is significant, ongoing, or paired with other symptoms, you may need something more. Your healthcare provider may suggest medication, physical therapy, or other treatments, depending on your diagnosis.
Surgery is rarely needed to treat calf pain, but it may be necessary for more severe injuries, such as a torn Achilles tendon or a blocked popliteal artery that won’t heal on its own.
RICE Method
The first treatment, in most cases, is to rest the muscles and allow the acute inflammation to lessen. A common approach is called the RICE method, which stands for:
Stretching and Physical Therapy
Stretching the muscles and tendons of the calf can help with some causes of calf pain. It’s important to stretch regularly and use proper stretching techniques to prevent further injuries.
Consult with a physical therapist to learn a stretching routine that suits your injury.
Physical therapy is an important part of treatment for almost all orthopedic conditions. Physical therapists use different techniques to help you increase strength, regain mobility, and return to your pre-injury level of activity.
Medications
Nonsteroidal anti-inflammatory medications (NSAIDs)like Advil (ibuprofen) and Aleve (naproxen) are some of the most commonly prescribed medications, especially for people with tendinitis or a muscle strain, contusion, or cramp.
Less commonly, acortisone steroid injectionmay be used to treat certain causes of calf pain.
If you are diagnosed with a blood clot, you will likely be placed on a blood thinner(anticoagulant), such as warfarin or Xarelto (rivaroxaban).Thesemedicationsprevent your current blood clot from getting bigger and new clots from forming.
There are some lifestyle habits you can adopt to prevent many causes of calf pain, especially muscle-related ones. These are just a few examples.
To prevent muscle cramps and strains in your calf:
Summary
If your pain is severe, persistent, or worsening, or if your symptoms worry you, don’t hesitate to consult a healthcare provider. Other symptoms of concern include an inability to walk comfortably, leg deformity, pain at night or while resting, swelling, or signs of an infection such as fever, redness, and warmth.
28 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Deep vein thrombosis.
Freedman BR, Gordon JA, Soslowsky LJ.The Achilles tendon: fundamental properties and mechanisms governing healing.Muscles Ligaments Tendons J. 2014 Jul;4(2):245-55.
Mcdermott MM.Lower extremity manifestations of peripheral artery disease: the pathophysiologic and functional implications of leg ischemia.Circ Res. 2015 Apr;116(9):1540-50. doi:10.1161/CIRCRESAHA.114.303517
John Hopkins Medicine.Claudication.
Johns Hopkins Medicine.Osteomyelitis.
John Hopkins Medicine.Tibia and fibula fractures.
Northwest Oklahoma Orthopaedic Clinic.Medial gastrocnemius strain.
Neutze D, Roque J.Clinical evaluation of bleeding and bruising in primary care.Am Fam Physician. 2016 Feb;93(4):279-285.
Conforti M.The treatment of muscle hematomas.Muscle Injuries in Sports Medicine. IntechOpen; Sep 2013. doi:10.5772/56903
Anloague PA, Strack DS.Considerations in the diagnosis and accelerated return to sport of a professional basketball player with a triceps surae injury: A case report.J Orthop Sports Phys Ther. 2018;48(5):388-397. doi:10.2519/jospt.2018.7192
The Stone Clinic.Plantaris injury.
Mount Sinai.Common peroneal nerve dysfunction.
Carolus AE, Becker M, Cuny J, Smektala R, Schmieder K, Brenke C.The interdisciplinary management of foot drop.Dtsch Arztebl Int. 2019 May;116(20):347-354. doi:10.3238/arztebl.2019.0347
Chen B, Liu H, Chen H, Chen L, Wang H.Arthroscopic-assisted treatment of popliteus tendinitis.Research Square. 2020 Oct;1(1):1-11. doi:10.21203/rs.3.rs-93184/v1
Lam CSE, Zhang M, Lim I.Primary care approach to calf cramps.Singapore Med J. 2022;63(12):746-752. doi:10.4103/SINGAPOREMEDJ.SMJ-2021-343
NHS Inform.Leg cramps.
Anang J.Case Report: Painful leg spasms in patient with hemifacial spasms and Vitamin D and vitamin B12 deficiency (2997).NeurologyApr 2021, 96 (15 Supplement) 2997.
Picerno V, Filippou G, Bertoldi I, et al.Prevalence of Baker’s cyst in patients with knee pain: an ultrasonographic study.Reumatismo. 2014 Mar;65(6):264-70. doi:10.4081/reumatismo.2013.715
MedlinePlus.Sciatica.
University of Maryland Medical Center.Popliteal artery entrapment syndrome.
Gaunder C, McKinney B, Rivera J.Popliteal artery entrapment or chronic exertional compartment syndrome?Case Rep Med. 2017 Aug;2017(1):1-5. doi:10.1155/2017/6981047
Somford MP, Hoornenborg D, Wiegerinck JI, Nieuwe weme RA.Are you positive that the Simmonds-Thompson test is negative? A historical and biographical review.J Foot Ankle Surg. 2016 May;55(3):682-3. doi:10.1053/j.jfas.2016.01.021
Pulivarthi S, Gurram MK.Effectiveness of d-dimer as a screening test for venous thromboembolism: an update.N Am J Med Sci. 2014;6(10):491-9. doi:10.4103/1947-2714.143278
Mercy Health.Thigh or Calf Strains.
Mackman N.Triggers, targets and treatments for thrombosis.Nature. 2008;451(7181):914-8. doi:10.1038/nature06797
American Heart Association.Prevention and treatment of PAD.
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